Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $269.15 / $457.09	Professional		$194.98	$269.15	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.90 / $104.71	Professional	26	$30.90	$38.90	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $223.87 / $478.63	Professional	TC	$165.96	$223.87	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $295.12	Professional		$141.25	$141.25	$295.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $38.02	Professional	26	$18.62	$18.62	$38.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $257.04	Professional	TC	$123.03	$123.03	$257.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $275.42 / $316.23	Professional		$38.90	$275.42	$316.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $40.74 / $43.65	Professional	26	$37.15	$40.74	$43.65
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $245.47 / $257.04	Professional	TC	$234.42	$245.47	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $537.03	Professional		$100.00	$181.97	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.30 / $77.62	Professional	26	$19.05	$26.30	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $162.18 / $467.74	Professional	TC	$77.62	$162.18	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $389.05	Professional		$263.03	$338.84	$389.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $46.77 / $54.95	Professional	26	$38.90	$46.77	$54.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $288.40 / $331.13	Professional	TC	$223.87	$288.40	$331.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
Sentara Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $263.03 / $645.65	Professional		$60.26	$263.03	$645.65
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $63.10 / $95.50	Professional	26	$51.29	$63.10	$95.50
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $251.19 / $660.69	Professional	TC	$181.97	$251.19	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $288.40 / $660.69	Professional		$158.49	$288.40	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $45.71 / $93.33	Professional	26	$27.54	$45.71	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $234.42 / $562.34	Professional	TC	$125.89	$234.42	$562.34